Provider Demographics
NPI:1043893019
Name:WEST, KIMBERLY JEAN (LMHC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JEAN
Last Name:WEST
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81448
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-1448
Mailing Address - Country:US
Mailing Address - Phone:808-298-3612
Mailing Address - Fax:
Practice Address - Street 1:1760 HONOAPIILANI HWY UNIT 12123
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-5085
Practice Address - Country:US
Practice Address - Phone:808-463-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health